Self Instructional Manual for Cancer Registrars - SEER - National ...

EXAMPLE G3 continued
grossly to within 0.5 cm of muscle. Sections are submitted according to the following
code: DE - deep surgical resection margins; SU, LA, INF, ME -- full thickness radial
samplings from the center of the tumor superiorly, laterally, inferiorly and medially,
respectively; NI - nipple and subjacent tissue. Lymph nodes dissected free from axillary
fibrofatty tissue from levels I, II, and III will be labeled accordingly.
MICROSCOPIC:
Sections of part #1 confirm frozen section diagnosis of infiltrating duct carcinoma. It is
to be noted that the tumor cells show considerable pleomorphism, and mitotic figures are
frequent (as many as 4 per high power field). Many foci of calcification are present within
the tumor.
Part #2 consists of fibrofatty tissue and a single tiny lymph node free of disease.
Part #3 includes 18 lymph nodes, three from Level III, two from Level II and thirteen
from Level I. All lymph nodes are free of disease with the exception of one Level I
lymph node which contains several masses of metastatic carcinoma.
All sections taken radially from the superficial center of the resection site fail to include
tumor, indicating the tumor to have originated deep within the breast parenchyma.
Similarly, there is no malignancy in the nipple region, or in the lactiferous sinuses.
Sections of deep surgical margin demonstrate diffuse tumor infiltration of deep fatty
tissues, however, there is no invasion of muscle. Total size of primary tumor is estimated
to be 4 cm in greatest dimension.
DIAGNOSIS:
1. Infiltrating duct carcinoma, left breast.
2. Metastatic carcinoma, left axillary lymph node (1), Level I.
3. Lymph nodes, no pathologic diagnosis, left axilla, Level I (12), Level II (2), Level III
(3).
Justin A. Glance, MD
Pathologist
Name Lilly McDermott Reg. No. 000039
2O6